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  • 1.
    Albrektsson, Tomas
    et al.
    Malmö högskola, Fakulteten för teknik och samhälle (TS), Institutionen för materialvetenskap och tillämpad matematik (MTM).
    Buser, Daniel
    Sennerby, Lars
    On Crestal/Marginal Bone Loss Around Dental Implants2012Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 27, nr 4, s. 736-738Artikel i tidskrift (Övrigt vetenskapligt)
  • 2.
    Albrektsson, Tomas
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Biofilms Research Center for Biointerfaces.
    Dahlin, Christer
    Reinedahl, David
    Tengvall, Pentti
    Trindade, Ricardo
    Wennerberg, Ann
    An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper2020Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 35, nr 3, s. 495-502Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this paper is to present evidence that supports the notion that the primary reason behind marginal bone loss and implant failure is immune-based and that bacterial actions in the great majority of problematic cases are of a secondary nature. Materials and Methods: The paper is written as a narrative review. Results: Evidence is presented that commercially pure titanium is not biologically inert, but instead activates the innate immune system of the body. For its function, the clinical implant is dependent on an immune/inflammatory defense against bacteria. Biologic models such as ligature studies have incorrectly assumed that the primary response causing marginal bone loss is due to bacterial action. In reality, bacterial actions are secondary to an imbalance of the innate immune system caused by the combination of titanium implants and ligatures, ie, nonself. This immunologic imbalance may lead to marginal bone resorption even in the absence of bacteria. Conclusion: Marginal bone loss and imminent oral implant failure cannot be properly analyzed without a clear understanding of immunologically caused tissue responses.

  • 3.
    Alenezi, Ali
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Biofilms Research Center for Biointerfaces.
    Chrcanovic, Bruno
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Biofilms Research Center for Biointerfaces.
    Wennerberg, Ann
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Biofilms Research Center for Biointerfaces.
    Effects of Local Drug and Chemical Compound Delivery on Bone Regeneration Around Dental Implants in Animal Models: A Systematic Review and Meta-Analysis2018Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 33, nr 1, s. e1-e18Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose: One of the suggested methods for enhancing osseointegration is the local application of drug agents around implant surfaces. The aim of this review was to evaluate the methods most commonly used for local drug and chemical compound delivery to implant sites and assess their influence on osseointegration. Materials and Methods: An electronic search was undertaken in three databases (PubMed, Scopus, Embase). The search was limited to animal experiments using endosseous implants combined with local drug delivery systems. Meta-analyses were performed for the outcome bone-to-implant contact (BIC). Results: Sixty-one studies met the inclusion criteria. Calcium phosphate (CaP), bisphosphonates (BPs), and bone morphogenetic proteins (BMPs) were the most commonly used chemical compounds. There were two main methods for local drug delivery at the bone-implant interface: (1) directly from an implant surface by coating or immobilizing techniques, and (2) the local application of drugs to the implant site, using carriers. There was a statistically significant increase in BIC for both local drug delivery methods (P = .02 and P < .0001, respectively) compared with the control methods. There was a statistically significant increase in BIC when CaP (P = .0001) and BMPs (P = .02) were either coating implants or were delivered to the implant site, in comparison to when drugs were not used. The difference was not significant for the use of BPs (P = .15). Conclusion: It is suggested that the use of local chemical compound delivery systems around implants could significantly improve implant osseointegration in animal models. It is a matter of debate whether these in vivo results might have some significant effect in the human clinical setting in the long term.

  • 4. Antonoglou, Georgios N.
    et al.
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Samara, Maria D.
    Ioannidis, Alexis
    Benic, Goran I.
    Papageorgiou, Spyridon N.
    Sandor, George K.
    Clinical Performance of Dental Implants Following Sinus Floor Augmentation: A Systematic Review and Meta-Analysis of Clinical Trials with at Least 3 Years of Follow-up2018Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 33, nr 3, s. E45-E65Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this systematic review was to assess the survival of implants placed in augmented sinuses on a medium-to long-term basis, and identify factors affecting implant survival such as surgical technique, bone grafts, and timing of implant placement. Materials and Methods: A literature search up to July 2016 was performed to identify prospective clinical studies on sinus floor augmentation in conjunction with implant placement with a minimum follow-up of 3 years. Meta-analytic methods were implemented to calculate implant survival rates and relative risks (RR) for failure and the effect of surgical technique, use of bone graft, graft type, use of membrane, mean residual bone height, and timing of implant insertion. Results: A total of 17 clinical trials (1 randomized and 16 prospective nonrandomized) were included, which pertained to 637 patients (at least 48% male) and 1,610 implants placed after sinus floor augmentation with the osteotome (transalveolar) or lateral window approach. The pooled implant survival rate at 3 to 6 years of follow-up was 97.7% (17 studies; 95% CI = 94.4% to 99.7%) with high heterogeneity. Smoking was associated with significantly worse implant survival (2 studies; RR = 4.8; 95% CI = 1.2 to 19.4; P < .05). However, evidence of influencing factors varied from very low to moderate after adopting the GRADE approach, due to risk of bias, imprecision, inconsistency, and small-study effects. Conclusion: Current evidence suggests that implants in augmented sinuses have high survival rates, with smoking playing a potentially important negative role in their prognosis. Both indirect and direct maxillary sinus floor augmentation seem to have a low frequency of manageable complications.

  • 5.
    Aparicio, Carlos
    et al.
    ZAGA Ctr Barcelona, Dept Zygomat Implantol, Hepler Bone Clin, Roman Macaya 22-24, Barcelona 08022, Spain..
    Lopez-Piriz, Roberto
    Adv Oral Surg Inst ICOA, Madrid, Spain..
    Albrektsson, Tomas
    Malmö universitet, Odontologiska fakulteten (OD).
    ORIS Criteria of Success for the Zygoma-Related Rehabilitation: The (Revisited) Zygoma Success Code2020Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 35, nr 2, s. 366-378Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Zygomatic-related implant rehabilitation differs from traditional implant treatment in biomechanics, clinical procedures, outcomes, and eventual complications such as soft tissue incompetence or recession that may lead to recurrent sinus/soft tissue complications. The extreme maxillary atrophy that indicates the use of zygomatic implants prevents use of conventional criteria to describe implant success/failure. Currently, results and complications of zygomatic implants reported in the literature are inconsistent and lack a standardized systematic review. Moreover, protocols for the rehabilitation of the atrophic maxilla using zygomatic implants have been in continuous evolution. The current zygomatic approach is relatively new, especially if the head of the zygomatic implant is located in an extramaxillary area with interrupted alveolar bone around its perimeter. Specific criteria to describe success/survival of zygomatic implants are necessary, both to write and to read scientific literature related to zygomatic implant-based oral rehabilitations. The aim of this article was to review the criteria of success used for traditional and zygomatic implants and to propose a revisited Zygomatic Success Code describing specific criteria to score the outcome of a rehabilitation anchored on zygomatic implants. The ORIS acronym is used to name four specific criteria to systematically describe the outcome of zygomatic implant rehabilitation: offset measurement as evaluation of prosthetic positioning; rhino-sinus status report based on a comparison of presurgical and postsurgical cone beam computed tomography in addition to a clinical questionnaire; infection permanence as evaluation of soft tissue status; and stability report, accepting as success some mobility until dis-osseointegration signs appear. Based on these criteria, the assessment of five possible conditions when evaluating zygomatic implants is possible.

  • 6.
    Bergkvist, Göran
    et al.
    Implantatctr, Kneippgatan 4, SE-60236 Norrköping, Sweden.
    Koh, Kwang-Joon
    Chonbuk Natl Univ, Sch Dent, Dept Oral & Maxillofacial Radiol, Jeonju, South Korea.
    Sahlholm, Sten
    Linköping Univ Hosp, Dept Oral & Maxillofacial Surg, S-58185 Linköping, Sweden.
    Klintström, Eva
    Linköping Univ Hosp, Dept Radiol, S-58185 Linköping, Sweden.
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Bone density at implant sites and its relationship to assessment of bone quality and treatment outcome2010Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 25, nr 2, s. 321-328Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To investigate the relationship between bone mineral density (BMD) before implant placement, implant stability measures at implant placement, and marginal bone loss of immediately loaded implants after 1 year in situ. MATERIALS AND METHODS: Consecutively recruited patients received Straumann SLActive implants loaded with fixed provisional prostheses within 24 hours. BMD was measured from computed tomographic images before implant placement. Alveolar bone quality was assessed during surgery. Implant stability-both rotational and as measured with resonance frequency analysis-and marginal bone height were assessed at implant placement and after 1 year. The Pearson correlation coefficient was used to calculate correlations, and significance was considered when P < .05. RESULTS: Twenty-one patients received 137 implants (87 in maxillae and 50 in mandibles). BMD was significantly correlated with bone quality classification in both arches (P < .001). Mean BMD was also significantly correlated with stability values (P < .001). Mean marginal bone loss at implant surfaces differed, but not significantly, at the 1-year follow-up, regardless of BMD values (P = .086) and measured stability (rotational stability P = .34, resonance frequency analysis P = .43) at implant placement. CONCLUSION: Within the limits of this study, it can be concluded that computed tomographic examination can be used as a preoperative method to assess jawbone density before implant placement, since density values correlate with prevailing methods of measuring implant stability. However, in the short time perspective of 1 year, there were no differences in survival rates or changes in marginal bone level between implants placed in bone tissue of different density.

  • 7. Bergkvist, Göran
    et al.
    Sahlholm, Sten
    Karlsson, Ulf
    Nilner, Krister
    Malmö högskola, Odontologiska fakulteten (OD).
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Immediately Loaded Implants Supporting Fixed Prostheses in the Edentulous Maxilla: A Preliminary Clinical and Radiologic Report2005Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 20, nr 3, s. 399-405Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    PURPOSE: To evaluate the survival rate of immediately loaded ITI sand-blasted, large-grit, acid-etched (SLA) solid-screw dental implants in the edentulous maxilla after 8 months of loading. MATERIALS AND METHODS: Twenty-eight patients (mean age 63 years) with edentulous maxillae each received 6 implants and 1 implant-supported fixed provisional prosthesis within 24 hours after surgery. After a mean healing time of 15 weeks, the patient received a definitive, screw-retained, implant-supported fixed prosthesis. A total of 168 implants were placed. Clinical parameters were registered after 1 month of loading with the implant-supported fixed prostheses as well as 8 months after implant placement. Radiologic examinations and assessments were made at implant placement and after 8 months. RESULTS: The mean marginal bone level at implant placement was 1.6 mm (range 0 to 5.1; SD 1.1) apical of the reference point (the implant shoulder). The mean marginal bone level at the 8-month follow-up was 3.2 mm (range 0.4 to 5.9; SD 1.1) apical of the reference point. Three implants failed during the healing period. DISCUSSION: The improved results in the present study might be a result of the positive effect of splinting the implants immediately after placement. CON-CLUSION: ITI SLA solid-screw implants immediately loaded (ie, loaded within 24 hours of placement) and supporting fixed prostheses had successful survival rates after 8 months. The present results constitute a solid baseline for future follow-up studies.

  • 8. Bonfante, Estevam Augusto
    et al.
    Granato, Rodrigo
    Marin, Charles
    Jimbo, Ryo
    Malmö högskola, Odontologiska fakulteten (OD).
    Giro, Gabriela
    Suzuki, Marcelo
    Coelho, Paulo
    Biomechanical testing of microblasted, acid-etched/microblasted, anodized, and discrete crystalline deposition surfaces: an experimental study in beagle dogs2013Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 28, nr 1, s. 136-142Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Modifications in implant surface topography and chemistry may alter the early bone response at different levels. This study characterized four implant surfaces and evaluated the biomechanical fixation and histologic response at early implantation times in a canine radius model. MATERIALS AND METHODS: External-hexagon Branemark-type implants were used with four experimental surfaces: microblasted (MI), acid-etched and microblasted (AAM), anodized (A), and discrete crystalline deposition (DCD). Surface topography was assessed by scanning electron microscopy, interferometry, and x-ray photoelectron spectroscopy. The implants were placed in the central region of the radii of eight beagle dogs and remained in vivo for 10 or 30 days. The implants were torqued to interface failure, and a general linear statistical model with torque as the dependent variable and implant surface and time in vivo as independent variables was used. RESULTS: All surfaces presented were textured, and different surface chemistries were observed. No significant differences between implant surfaces were observed for torque at 10 days. However, at 30 days, the AAM surface presented significantly higher torque values compared to the DCD and A surfaces. Significantly higher torque values were observed at 30 days compared to 10 days (P < .001). CONCLUSIONS: Significantly different biomechanical fixation dependent on surface preparation was observed after 30 days, and all surfaces were biocompatible and osteoconductive.

  • 9.
    Braian, Michael
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    De Bruyn, Hugo
    Malmö högskola, Odontologiska fakulteten (OD).
    Fransson, Håkan
    Christersson, Cecilia
    Malmö högskola, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Tolerance Measurements on Internal- and External-Hexagon Implants2014Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 29, nr 4, s. 846-852Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To measure the horizontal machining tolerances of the interface between internal-and external-hexagon implants and analogs with corresponding components after delivery from the manufacturer. These values may be a valuable tool for evaluating increasing misfit caused by fabrication, processing, and wear. Materials and Methods: Seven implants and seven analogs with external-and internal-hexagon connections (Biomet 3i) with corresponding prefabricated gold cylinders and gold screws, prefabricated cylindric plastic cylinders, and laboratory screws were studied. One set of components from the external and internal groups was measured manually and digitally. Measurements from the test subjects were compared with identical measurements from the virtual model to obtain threshold values. The virtual model was then used to obtain optimally oriented cuts. Results: The horizontal machining tolerances for castable plastic abutments on external implants were 12 +/- 89 mu m, and for internal implants they were 86 +/- 47 mu m. Tolerance measurements on prefabricated gold abutments for external implants were 44 +/- 9 mu m, and for internal implants they were 58 +/- 28 mu m. Conclusion: The groups with metallic components showed the smallest tolerance at < 50 mu m for the external group and < 90 mu m for the internal group. The prefabricated plastic cylinder groups ranged from < 100 mu m for external and < 130 mu m for internal connection.

  • 10.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Kisch, Jenö
    Albrektsson, Tomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Intake of Proton Pump Inhibitors Is Associated with an Increased Risk of Dental Implant Failure2017Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 32, nr 5, s. 1097-1102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To investigate the association between the intake of proton pump inhibitors (PPIs) and the risk of dental implant failure. Materials and Methods: The present retrospective cohort study is based on patients consecutively treated between 1980 and 2014 with implant-supported/retained prostheses at one specialist clinic. Modern endosseous dental implants with cylindrical or conical design were included, and only complete cases were considered; ie, only those implants with information available for all variables measured were included in the regression model analysis. Zygomatic implants and implants detected in radiographies but without basic information about them in the patients’ files were excluded from the study. Implant- and patient-related data were collected. Multilevel mixed-effects parametric survival analysis was used to test the association between PPI exposure (predictor variable) and risk of implant failure (outcome variable), adjusting for several potential confounders. Results: A total of 3,559 implants were placed in 999 patients, with 178 implants reported as failures. The implant failure rates were 12.0% (30/250) for PPI users and 4.5% (148/3,309) for nonusers. A total of 45 out of 178 (25.3%) failed implants were lost up to abutment connection (6 in PPI users, 39 in nonusers), with an early-to-late failure ratio of 0.34:1. The intake of PPIs was shown to have a statistically significant negative effect for implant survival rate (HR 2.811; 95% CI: 1.139 to 6.937; P = .025). Bruxism, smoking, implant length, prophylactic antibiotic regimen, and implant location were also identified as factors with a statistically significant effect on the implant survival rate. Conclusion: This study suggests that the intake of PPIs may be associated with an increased risk of dental implant failure.

  • 11. Cochran, David
    et al.
    Stavropoulos, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    Obrecht, Marcel
    Pippenger, Benjamin
    Dard, Michel
    A Comparison of Tapered and Nontapered Implants in the Minipig2016Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 31, nr 6, s. 1341-1347Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Tapered implants are thought to result in equivalent long-term stability and marginal peri-implant bone height in comparison to cylindrical implants. The goal of this study was to compare the primary stability and osseointegration of a novel bone-level tapered-wall implant to a control bone-level cylindrical implant with exactly the same surface characteristics, in a direct side-by-side comparison in an animal model. MATERIALS AND METHODS: Mandibular premolars and first molars were extracted in 11 G.ttingen minipigs, and healing was allowed for 3 months. Six implants were placed with a 4-week surgical lag time between hemimandibles (three per side), and either immediately loaded (first implantation time point) or submerged (second implantation time point). Eight-mm-long × 4.1-mm-diameter titanium screw-type bone-level implants with tapered (two per side) and cylindrical bodies (one per side) were used (Institut Straumann); insertion torque and implant stability were measured, and the soft tissue was closed. Standardized radiographs were taken at implant placement and at sacrifice. Following a healing period of 1 month from the last surgical intervention (8 weeks total healing time for loaded implants; 4 weeks total healing time for nonloaded implants), the animals were sacrificed and mandibular blocks were harvested for nondecalcified histologic and histomorphometric analysis. RESULTS: All implants were integrated radiographically and osseointegrated histologically. Maximum insertion torque measurements and implant stability quotient values showed no significant difference between tapered and cylindrical implants. Histomorphometric analysis also resulted in comparable bone-to-implant contact values between the implant types and similarly limited marginal peri-implant bone resorption; no significant differences were observed regarding all the evaluated parameters between the groups, regardless of the loading regime. CONCLUSION: In a direct side-by-side comparison, in an intraoral minipig model, a novel bone-level tapered screw implant with an SLActive surface showed comparable clinical and histologic outcomes to a parallel-walled bone-level screw implant with an SLActive surface.

  • 12. Cooper, Lyndon F.
    et al.
    Reside, Glenn J.
    Raes, Filiep
    Soliva Garriga, Joan
    Giner Tarrida, Luis
    Wiltfang, Jörg
    Kern, Matthias
    De Bruyn, Hugo
    Malmö högskola, Odontologiska fakulteten (OD).
    Immediate Provisionalization of Dental Implants Placed in Healed Alveolar Ridges and Extraction Sockets: A 5-year Prospective Evaluation2014Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 29, nr 3, s. 709-717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This 5-year prospective multicenter study compared implant survival and success, peri-implant health and soft tissue responses, crestal bone level stability, and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets. Materials and Methods: Individuals requiring anterior tooth replacement with single implants were treated and immediately provisionalized. Definitive all-ceramic crowns were placed at 12 weeks. Implant survival, bone levels, soft tissue levels, and peri-implant health were monitored for 5 years. Results: One hundred thirteen patients received implants in fresh sockets (55) and healed ridges (58). After 5 years, 45 and 49 patients remained for evaluation, respectively. During the first year, three implants failed in the extraction socket group (94.6% survival) and one implant failed in the healed ridge group (98.3% survival); this difference was not significant. No further implant failures were recorded. After 5 years, the interproximal crestal bone levels were located a mean of 0.43 +/- 0.63 mm and 0.38 +/- 0.62 mm from the reference points of implants in sockets and healed ridges (not a significant difference). In both groups, papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges. Compared to flap surgery for implants in healed ridges, flapless surgery resulted in increased peri-implant mucosal tissue dimension (average, 0.78 +/- 1.34 mm vs 0.19 +/- 0.79 mm). Conclusion: After 5 years, the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges. The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and, under ideal circumstances, extraction sockets.

  • 13.
    Duddeck, Dirk U.
    et al.
    Charite Univ Med Berlin, Dept Prosthodont Geriatr Dent & Craniomandibular, Berlin, Germany.
    Albrektsson, Tomas
    Malmö universitet, Odontologiska fakulteten (OD). Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Biomat, Gothenburg, Sweden.
    Wennerberg, Ann
    Univ Gothenburg, Sahlgrenska Acad, Inst Odontol, Dept Prosthodont, Gothenburg, Sweden.
    Larsson, Christel
    Malmö universitet, Odontologiska fakulteten (OD).
    Mouhyi, Jaafar
    Int Univ Agadir Universiapolis, Agadir, Morocco.
    Beuer, Florian
    Charite Univ Med Berlin, Dept Prosthodont Geriatr Dent & Craniomandibular, Berlin, Germany.
    Quality Assessment of Five Randomly Chosen Ceramic Oral Implant Systems: Cleanliness, Surface Topography, and Clinical Documentation2021Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 36, nr 5, s. 863-874Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: After some initial setbacks in the 1970s, ceramic implants seem to be a promising alternative to titanium implants. Since the surface of an implant system represents the interface to surrounding biologic structures, the study focuses on cleanliness and surface topography. Clinical documentation of the corresponding systems completes the picture and allows a better evaluation of zirconia implant systems. Materials and Methods: Five different ceramic implant systems were selected randomly and purchased via blind-shopping: Z5s (Z-Systems), ZiBone (COHO), W implant (TAVDental), ceramic. implant (vitaclinical), and BioWin!/Standard Zirkon Implantat (Champions-Implants/ZV3 system). Three samples of each implant system underwent scanning electron microscopy (SEM) imaging and elemental analysis (EDS). Where appropriate, subsequent Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS) was performed to identify the chemical nature of impurities. Surface topography was evaluated, and a search for clinical trials in the PubMed database, on the websites and by written request to each dental implant manufacturer, was performed. Results: Surfaces of Champions implants (ZV3) and Z-Systems implants were relatively clean, whereas the other investigated surfaces of vitaclinical, TAV Dental, and ZiBone implants all displayed organic contaminations on their surfaces. Four of the investigated ceramic implants showed a moderately rough implant surface. Only the vitaclinical ceramic.implant had minimal surface roughness. Three ceramic designs—vitaclinical, ZV3, and Z-Systems—had clinical trials documented with up to 3 years of follow-up and results varying between 82.5% and 100% survival. TAV Dental W and ZiBone implant systems lacked properly conducted clinical recording of results. Conclusion: The results of this study showed that it is technically possible to produce zirconia implants that are largely residue-free. On the other hand, the variety of significant residues found in this analysis raises concerns, as contamination may lead to undesirable biologic effects. The lack of clinical studies in peer-reviewed journals does not seem to be relevant for the approval of marketing, nor does the lack of surface cleanliness. In the authors’ opinion, a critical analysis of these aspects should be included in a more stringent future analysis prior to the marketing of oral implant systems.

  • 14.
    Gjelvold, Björn
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Chrcanovic, Bruno
    Malmö högskola, Odontologiska fakulteten (OD).
    Collin Bagewitz, Ingrid
    Kisch, Jenö
    Albrektsson, Tomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Esthetic and Patient-Centered Outcomes of Single Implants: A Retrospective Study2017Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 32, nr 5, s. 1065-1073Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aims of this clinical study were to retrospectively evaluate implant survival, patient satisfaction, and radiographic, clinical, and esthetic outcomes following single-implant treatment. Materials and Methods: Eighty-seven patients, with a total of 126 implants (XiVE S, Dentsply Implants), who received single implant-retained crowns between 2004 and 2011 were retrospectively evaluated. Implant survival, marginal bone levels (MBL), changes in implant/mesial tooth vertical relationship, pink esthetic score (PES), white esthetic score (WES), patient assessment of the esthetics (visual analog scale), and oral health impact profile (OHIP-14) were evaluated. Results: Altogether, 59 patients with a total of 85 implants attended a final clinical and radiographic follow-up examination. The mean ages of males and females at implant placement were 19.78 and 22.58 years, respectively. The mean total follow-up time from the implant surgical date was 7.51 years. The 5-year implant clinical survival rate (CSR) was 98.4% (95% CI: 96.3%–100%), and crown CSR was 91.8% (95% CI: 86.3%–97.3%). The overall mean change in MBL was –0.19 mm. No significant differences were found between the different implant diameters (3.0, 3.4, and 3.8 mm) with regard to change in MBL. Mean increase in implant infraposition was 0.13 mm. With regard to esthetics, mean initial and final total PES were 9.61 and 11.49, respectively (P < .001). The mean WES was 6.48 at follow-up. Patients’ mean assessment of soft tissue esthetics and implant-supported crown appearance were 73.5 and 82.1 (maximum score 100). At the follow-up examination, the additive OHIP-14 score was 16.11. Conclusion: This retrospective study of XiVE S implants found excellent survival rates and showed good clinical outcomes concerning patient-centered findings, esthetics, and marginal bone preservation. In context, it is important to stress that this study consisted of mostly young patients with agenesis who were treated by experienced clinicians.

  • 15.
    Jimbo, Ryo
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Halldin, Anders
    Malmö högskola, Odontologiska fakulteten (OD).
    Janda, Martin
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Vandeweghe, Stefan
    Vertical fracture and marginal bone loss of internal-connection implants: a finite element analysis2013Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 28, nr 4, s. 171-176Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: Marginal bone loss around implants is of great concern, and its cause may be multifactorial. Recently, clinical cases presenting marginal bone loss, in most cases accompanied by vertical fracture of internal-connection implants in the buccolingual direction, have been reported, in which unfavorable stress distribution is one possible cause of marginal bone resorption. The purpose of the current study was to characterize this type of marginal bone loss and implant fracture by conducting a finite element analysis (FEA). MATERIALS AND METHODS: Clinical and radiographic evaluations showed that the prostheses of all reported cases had implant-level setups and were directly screwed to the internal implants. Intriguingly, all vertical fractures reported were in the buccolingual direction. Therefore, to characterize the specific implant fractures, FEA was conducted with misfit models created for two different setups, abutment-level and implant-level, both with screw-retained prostheses. The models were subjected to initial misfits of 0 μm (representing perfect fit), 50 μm, 100 μm, 150 μm, or 200 μm, and vertical loading was then applied. RESULTS: FEA revealed that, for the implant-level setup, excessive stress at the neck of the implant gradually increased in the buccolingual direction as the misfit increased. This result was not seen for the abutment-level setup. A broad maximum stress distribution was evident for the implant-level setup but not for the abutment-level setup. CONCLUSION: Broad distribution of excessive stress in the FEA correlated to the clinical cases, and marginal bone loss in these cases may be associated with mechanical alterations. To avoid unnecessary complications, selection of an abutment-level setup is strongly suggested.

  • 16.
    Jinno, Yohei
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Lindström, Martin
    Malmö universitet, Odontologiska fakulteten (OD).
    Sawase, Takashi
    Lilin, Thomas
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Vertical Bone Augmentation Using Ring Technique with Three Different Materials in the Sheep Mandible Bone2018Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 33, nr 5, s. 1057-1063Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this study was to examine the volumetric alterations and osseointegration properties in the augmented area of the ring technique using different types of bone graft material in sheep mandible bone. Materials and Methods: Three different materials (columnar forms, 7-mm diameter, 3-mm height) were stabilized using dental implants with a turned surface in the mandible bone of Finnish Dorset cross-bred sheep: group A, autogenous bone; group B, bovine bone; group C, biphasic bone substitute. Animals were euthanized after 5 weeks (N = 6). Three-dimensional image data by digital oral scanner were taken at the surgery and sacrifice, and the volume alteration of the material was calculated. The bone samples were fixed in formalin and dehydrated in ethanol. Resin-embedded samples were subjected to non-decalcified ground sectioning, and histologic and histomorphometric analysis (bone and material area alteration, bone-to-implant contact [BIC]) were done. Results: In three-dimensional (3D) image analysis, group A showed a statistically higher percentage of remaining materials compared with groups B and C. The histologic observation showed no new bone formations around the implants in all groups, especially at the maxillary site of the implant in the augmented area. In histomorphometric analysis, group A showed a statistically higher percentage of bone area (BA) compared with groups B and C; however, in all groups, bone-to-implant contact (BIC) showed low values, and there were no statistical differences between groups. Conclusion: The results of this study suggested that the autogenous bone maintained bone volume around the dental implant using the ring technique, and the impact of surface properties was of some importance; osseointegration with the turned surface in the augmented area showed low BIC values in all groups.

  • 17. Johansson, Lars-Åke
    et al.
    Isaksson, Sten
    Malmö högskola, Odontologiska fakulteten (OD).
    Bryington, Matthew
    Dahlin, Christer
    Evaluation of bone regeneration after three different lateral sinus elevation procedures using micro-computed tomography of retrieved experimental implants and surrounding bone: a clinical, prospective, and randomized study.2013Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 28, nr 2, s. 579-586Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To compare three different lateral sinus elevation procedures concerning new bone formation by using micro-computed tomography (micro-CT) of retrieved implants. MATERIALS AND METHODS: Twenty-four consecutive partially dentate patients with a mean age of 64 years were included in the study and provided with 30 sinus elevation procedures. Three procedures for lateral sinus elevation were used: lateral sinus elevation with replacement of bone window and without bone graft (BW), lateral sinus elevation and covering osteotomy site with a collagen membrane and without bone graft (CM), and lateral sinus elevation with autogenous bone graft (ABG). Experimental implants were retrieved after 7 months of healing and analyzed by micro-CT. RESULTS: One implant was found not to be integrated at the time of implant retrieval. This implant belonged to group CM and was excluded when calculating bone-to-implant contact (BIC) and intrasinus bone levels. The integrity of the lateral sinus bony wall was determined at the time of implant removal. In group ABG, all lateral sinus walls were ossified. In group BW, one lateral sinus wall was not completely ossified and in group CM, two lateral sinus walls. There were no statistical differences in %BIC between the groups: 93.5% (BW), 92.0% (CM) and 93.5% (ABG). Additionally, no statistical differences were found in apical intrasinus bone levels between the groups. When surfaces were compared within the same implant, a statistical difference was found between the apicobuccal distance and the apicolingual distance. The mean apicobuccal distances/apicolingual distances were 0.6 mm/1.2 mm for the BW group, 0.5 mm/0.8 mm for the CM group, and 0.6 mm/0.8 mm for the ABG group (P = .003). CONCLUSIONS: All three procedures were statistically equal when new bone formation was compared. Most of the examined implants' apices were not covered with bone at the time of retrieval.

  • 18. Jokstad, Asbjørn
    et al.
    Sanz, Mariano
    Ogawa, Takahiro
    Bassi, Francesco
    Levin, Liran
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Romanos, Georgios E
    A Systematic Review of the Role of Implant Design in the Rehabilitation of the Edentulous Maxilla2016Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 31, nr Suppl, s. S43-S99Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose: To identify and critically appraise scientific publications evaluating the possible effect of implant design on treatment outcomes in the rehabilitation of patients with a fully edentulous maxilla. Materials and Methods: Scientific reports were sought in three electronic bibliographic databases, combined with searches for meeting abstracts, and in the grey literature. English, German, or Scandinavian scientific publications on prospective or retrospective longitudinal studies with effects of an implant design or feature on the treatment outcomes were eligible. Minimum requirement for inclusion was at least 10 study participants who were followed up for at least 2 years after implant loading. The PRISMA guidelines were followed for selecting data to extract from the individual studies. These were characteristics of the individual studies, risk of bias within individual studies, and the results of individual studies. Three editorial teams independently identified and extracted the data. Results: The search resulted in 998 primary studies, of which 525 met the inclusion criteria and were read in full text. Of these, 105 studies were included in qualitative syntheses. Seventeen studies were designed with an objective to assess effects of implant design or feature on outcomes, 23 studies described tilted implants to enable placement of longer implants, 30 studies reported effects of implants placed in zygomatic bone with or without additional alveolar implants, and 9 studies reported effects of implants placed in pterygoid bone or other bony buttresses with or without additional alveolar implants. Sixteen articles reported bone augmentation with simultaneous or delayed implant placement in patients with a predominantly Cawood-Howell bone class V and VI maxilla. Ten papers reported effects of implant design on outcomes, despite the lack of an a priori stated objective to assess a particular implant design or feature. There is a lack of compelling data to state that one particular implant system or design feature stands out amidst others, when applied to restoring the fully edentulous maxilla with implant-retained prostheses. Conclusion: This systematic review failed to identify compelling evidence to conclude that any particular implant or feature affects the treatment outcome in patients with a fully edentulous maxilla.

  • 19.
    Klinge, Anna
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Eldh, Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    Ulvan, Rasmus
    Malmö universitet, Odontologiska fakulteten (OD).
    Andersson, Lars
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Craniofacial Height in Relation to Cross-Sectional Morphology of the Anterior Maxilla: An Anatomica Considers ion in Implant Therapy2020Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 35, nr 2, s. 386-394Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Patients who have a vertical growth pattern are more prone to complete alveolar bone growth later and run a higher risk for inhibition of growth and infraposition after implants have been placed. Moreover, it has been suggested for the same category of patients that craniofacial height may influence the alveolar bone morphology of the anterior maxilla during growth. Hence, it is important to identify such patients early when considering implant treatment in young patients. The purpose of this study was to investigate the height and width of the alveolar bone in the anterior maxilla in subjects with different craniofacial heights to assess if there is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Materials and Methods: Measurements on cephalograms and cone beam computed tomography (CBCT) images of the maxilla from 180 fully dentate subjects were analyzed and categorized into three angle groups based on the craniofacial height: low-, normal-, and high-angle groups. Measurements of the alveolar bone were taken interradicular, at six reference points distributed between the first premolar regions in the maxilla. The height and width of the alveolar bone were measured with a standardized technique at 3, 6, 9, and 12 mm from the top of the alveolar process. Results: Significant differences were found regarding the height of the alveolar bone in all the subgroups and regarding the width in the 9- and 12-mm subgroups, and between low-/normal- and low-/high-angle groups, where the high-angle group represented the thinnest alveolar bone. A significant difference was found between male and female patients concerning all dimensions of the alveolar bone. Conclusion: There is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Craniofacial height is an important factor to analyze when implant treatment is considered in the maxillary anterior region. This identification can preferably be carried out early in young patients who are still growing when various treatment options can still be considered.

  • 20.
    Lindgren, Christer
    et al.
    Department of Oral and Maxillofacial Surgery, Gäve Country Hospital, Sweden.
    Mordenfeld, Arne
    Department of Oral and Maxillofacial Surgery, Gävle, County Hospital, Sweden/Dept of Biomaterials, Institute of Clinical Sciences, Göteborg University, Sweden.
    Johansson, Carina B
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Hallman, Mats
    Department of Oral and Maxillofacial Surgery, Gävle, County Hospital, Sweden/Department of Oral & Maxillofacial Surgery, Umeå University, Umeå Sweden and Center for Research and Development, Uppsala University/Gävleborg County Council, Swede.
    A 3-year clinical follow-up of implants placed in two different biomaterials used for sinus augmentation.2012Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 27, nr 5, s. 1151-1162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The aims of the present study were to compare a novel biphasic calcium phosphate (BCP) with deproteinized bovine bone (DBB) for maxillary sinus floor augmentation in a split-mouth design and to perform a clinical follow-up of dental implants placed in the augmented sinuses.

    MATERIALS AND METHODS: Partially or completely edentulous patients requiring bilateral sinus augmentation were included in the study. The patients were randomized for augmentation with BCP (test) and DBB (control) in the contralateral side. Eight months after grafting, dental implants were placed. After 3 years of graft healing, core biopsy specimens were obtained from the grafted areas for histologic and histomorphometric analyses. After 3 years of functional implant loading, implant survival/success rates and clinical indices were assessed and radiographic examination and resonance frequency analysis were performed.

    RESULTS: Nine completely edentulous patients and two partially edentulous patients (mean age, 67 years) who required bilateral sinus augmentation were included in the study, and 62 implants were placed. The mean values for the area of newly formed bone in the retrieved specimens were 29% ± 14.3% and 32% ± 18.0% for BCP and DBB, respectively; the percentage of graft particles in contact with bone was 38% ± 10.9% in the BCP group and 44% ± 12.1% in the DBB group (no statistical significant differences between groups). The mean values for the area of BCP particles and DBB particles were 20% ± 7.5% and 24% ± 13.5%, respectively (difference not significant). One dental implant was lost from each group, resulting in an overall implant survival rate of 96.8% after 3 years of loading.

    CONCLUSION: After 3 years, a similar amount of newly formed bone was present regardless of the biomaterial used. The choice of biomaterial did not seem to influence implant survival rates.

  • 21.
    Lindh, Christina
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Rohlin, Madeleine
    Malmö högskola, Odontologiska fakulteten (OD).
    Ribeiro-Rotta, Rejane Faria
    Efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement: a systematic literature review2007Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 22, nr 2, s. 289-300Artikel, forskningsöversikt (Övrigt vetenskapligt)
    Abstract [en]

    PURPOSE: To evaluate the evidence for the diagnostic accuracy of clinical methods to assess bone density, quantity, or quality prior to and during dental implant placement. MATERIALS AND METHODS: A PubMed literature search with specific indexing terms and a hand search were made. From the retrieved titles and abstracts, 3 reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. RESULTS: The literature search yielded 145 titles and abstracts, of which 71 were selected and read in full text. Seven studies were judged relevant. In 1 study, no method was presented as the test method. In 6 studies, the results of the test method were compared to those of a reference method. However, only 1 study presented the results in terms of percentage of correct diagnoses. In that study, the use of periapical radiography together with reference images yielded correct assessment of the trabecular pattern of the mandible in 3 categories in 58% of the sites. The kappa index of interobserver agreement was 0.35 and intraobserver agreement was 0.67. Corresponding kappa values for 4 classes of bone quality presented by Lekholm and Zarb were 0.33 and 0.43, respectively. No study examined the accuracy of the method originally described by Lekholm and Zarb. CONCLUSION: The evidence for the efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement is sparse. This emphasizes the need for studies that incorporate accepted methodologic criteria for diagnostic efficacy. PMID: 17465355 [PubMed - indexed for MEDLINE]

  • 22. Marao, Heloisa F.
    et al.
    Jimbo, Ryo
    Malmö högskola, Odontologiska fakulteten (OD).
    Neiva, Rodrigo
    Gil, Luiz Fernando
    Bowers, Michelle
    Bonfante, Estevam A.
    Tovar, Nick
    Janal, Malvin N.
    Coelho, Paulo G.
    Cortical and Trabecular Bone Healing Patterns and Quantification for Three Different Dental Implant Systems2017Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 32, nr 3, s. 585-592Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The present study hypothesized that different bone healing patterns through initial stages of osseointegration would be observed when three distinct commercially available implant systems (Nobel Groovy, Implacil, and Zimmer TSV) were used, leading to significant variations in histometric levels of total bone and new bone formation during the osseointegration process. Materials and Methods: A total of 48 implants were placed bilaterally on the tibias of eight beagle dogs and allowed to heal for 2 and 6 weeks. Following euthanasia, nondecalcified specimens were processed for morphologic and histometric evaluation. Bone-to-implant contact (BIC) and new bone area fraction occupancy (BAFO) analyses for native and new bone were performed along the whole perimeter of each implant and separately for the cortical and trabecular bone regions. Results: Morphologic evaluation of cortical bone presented different healing patterns and osseointegration levels for different implant systems as time elapsed in vivo. Interfacial remodeling was the chief healing pattern in Zimmer implants, while a combination of interfacial remodeling and healing chambers was observed in Nobel and Implacil implants. When trabecular bone was evaluated, similar bone healing patterns were observed between systems despite different levels of osseointegration observed as a function of implantation time, implant system, and native and/or new bone BIC and BAFO. Conclusion: Different implant systems led to different healing patterns during early stages of osseointegration. Such variation in pattern was more noticeable in the cortical regions compared to the trabecular regions. The variation in bone healing pattern did significantly influence overall indicators of native and new BIC and BAFO during the osseointegration process. The postulated hypothesis was accepted.

  • 23.
    Meirelles, Luiz
    et al.
    Sahlgrenska Academy at Göteborg University, Institute of Odontology, Department of Prosthodontics/Dental Materials Science, Göteborg, Sweden.
    Currie, Fredrik
    Promimic, Göteborg, Sweden.
    Jacobsson, Magnus
    Astra Tech, Mölndal, Sweden.
    Albrektsson, Tomas
    Sahlgrenska Academy at Göteborg University, Institute of Clinical Sciences, Department of Biomaterials, Göteborg, Sweden.
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    The effect of chemical and nanotopographical modifications on the early stages of osseointegration2008Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 23, nr 4, s. 641-647Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To investigate the effect of chemically modified implants with similar microtopographies but different nanotopographies on early stages of osseointegration. MATERIALS AND METHODS: Forty screw-shaped implants were placed in 10 New Zealand white rabbits. The implant surface modifications investigated in the present study were (1) blasting with TiO2 and further (2) fluoride treatment or (3) modification with nano-hydroxyapatite. Surface evaluation included topographical analyses with interferometry, morphologic analyses with scanning electron microscopy, and chemical analyses with x-ray photoelectron spectroscopy. Bone response was investigated with the removal torque test, and histologic analyses were carried out after a healing period of 4 weeks. RESULTS: Surface roughness parameters showed a slight decrease of the average height deviation for the fluoride-treated compared to the blasted (control) and nano-hydroxyapatite implants. Scanning electron microscopic images at high magnification indicated the presence of nanostructures on the chemically modified implants. Chemical analyses revealed the presence of titanium, oxygen, carbon, and nitrogen in all implant groups. The blasted-fluoride group revealed fluoride, and the blasted-nano HA group calcium and phosphorus with simultaneous decrease of titanium and oxygen. Removal torque values revealed an increased retention for the chemically modified implants that exhibit specific nanotopography. The histologic analyses demonstrated immature bone formation in contact with the implant surface in all groups, according to the healing period of the experiment. CONCLUSION: Chemical modifications used in the present study were capable of producing a particular nanotopography, and together with the ions present at the implant surface, may explain the increased removal torque values after a healing period of 4 weeks.

  • 24. Pimentel Lopes de Oliveira, Guilherme Jose
    et al.
    Freitas de Paula, Luiz Guilherme
    Spin-Neto, Rubens
    Stavropoulos, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    Spolidorio, Luis Carlos
    Marcantonio, Elcio, Jr.
    Chierici Marcantonio, Rosemary Adriana
    Effect of Avocado/Soybean Unsaponifiables on Osseointegration: A Proof-of-Principle Preclinical In Vivo Study2014Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 29, nr 4, s. 949-957Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To evaluate the influence of administration of avocado/soybean unsaponifiables (ASU) on implant osseointegration in rat tibiae. Materials and Methods: Thirty rats were randomly assigned into one of three equal-sized groups: (1) ASU1: administration of ASU starting 7 days prior to implant placement; (2) ASU2: administration of ASU starting on the day of implant placement, and (3) CTL: administration of saline solution. In all animals, one titanium implant was placed in each tibia. All animals received ASU or saline solution by gavage daily until sacrifice 60 days postoperatively. Implant osseointegration and bone maturation were assessed by biomechanical and radiographic bone density analysis; descriptive histology; immunohistochemistry for bone morphogenetic protein 2 (BMP-2), transforming growth factor beta 1 (TGF-beta 1), and osteocalcin; and histomorphometric evaluation of bone-to-implant contact (BIC) and mineralized bone area fraction within the threads of the implant. Results: ASU1 and ASU2 showed three times higher expression of BMP-2 and nine times higher expression of TGF-beta compared with CTL (P < .05). Histomorphometric analysis, however, showed that both ASU1 and ASU2 groups presented significantly higher BIC values only in the cortical bone compartment when compared to CTL (P < .05). Conclusion: ASU consumption seems to exert only a subtle effect on implant osseointegration.

  • 25. Rosa, MB
    et al.
    Albrektsson, Tomas
    Malmö högskola, Odontologiska fakulteten (OD).
    Francischone, CE
    Filho, HO
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Micrometric characterization of the implant surfaces from the five largest companies in Brazil, the second largest worldwide implant market2013Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 28, nr 2, s. 358-365Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To characterize the surface of implants from Brazilian companies by light interferometry and evaluate the level of control of the surface treatment process. MATERIALS AND METHODS: Oral implants from the five largest Brazilian companies were evaluated topographically. The surfaces of the implants were analyzed on the tops, valleys, and flanks of the threads, totaling nine measurements for each unit. The implants and results were separated in groups by their types of surface treatment and compared with well known international implants used as references. RESULTS: The implants examined presented a mean height deviation of less than 1 μm, which was considered minimally rough, except for the SIN-SW implant (1.01 μm) and the Vulcano Actives design (1.26 μm). The surface enlargement values varied considerably in relation to the reference implant, with lower values noted in the group of implants subjected to sandblasting and acid-etching and with higher values obtained in the group treated by acid-etching and anodizing. There were statistically significant differences between batches of implants from all companies assessed, indicative of a substantial variance in implant topography from one batch to another. CONCLUSIONS: The low values of roughness found in the measurements and the differences between the values of the batches suggest that these companies should consider improving their surface treatments to achieve more uniform roughness.

  • 26. Shanbhag, Siddharth
    et al.
    Shanbhag, Vivek
    Stavropoulos, Andreas
    Malmö högskola, Odontologiska fakulteten (OD).
    Volume changes of maxillary sinus augmentations over time: a systematic review2014Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 29, nr 4, s. 881-892Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The objective of this study was to systematically review the available literature on three-dimensional time-dependent graft volume changes after sinus augmentation (SA) with different biomaterials in humans. Materials and Methods: MEDLINE, EMBASE, and CENTRAL were searched for related literature. Controlled and uncontrolled studies reporting volume changes of more than 10 SAs after at least 6 months, assessed by computed tomography (CT) or cone beam CT (CBCT), were eligible for inclusion. The primary outcome of interest was time-dependent percentage change in augmentation volume. Results: Seven controlled and five uncontrolled studies (n = 234 SAs) with a high risk of bias were included and reported on a range of graft materials. Autogenous bone (AB) was used in the particulate or block form. Bone substitutes (BS) were used either alone or in combination with other materials as composite grafts (CG). All studies reported reductions in augmentation volumes over time (AVR), generally after short observation periods (range, 6 months to 6 years). Substantial AVRs (approximately 45% in 77 SAs) were reported for AB after 6 months and up to 2 years. AVRs for solely BS or CG were relatively lower (approximately 18% to 22% in 142 SAs) after a similar time period. All studies reported a wide range of volume reductions. No significant differences in AVR were observed between different graft materials. Because of insufficient long-term data, a reliable association between volume reduction and time could not be established. Conclusion: Some loss of augmentation volume always occurs after SA during early healing times. In general, less AVR may be expected after SA with BS or CG compared to SA with AB. Augmentation volume loss does not seem to compromise implant placement or survival.

  • 27.
    Stocchero, Michele
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Jinno, Yohei
    Kyushu Univ, Fac Dent Sci, Div Oral Rehabil, Sect Implant & Rehabilitat Dent, Fukuoka, Japan..
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Galli, Silvia
    Malmö universitet, Odontologiska fakulteten (OD).
    Papia, Evaggelia
    Malmö universitet, Odontologiska fakulteten (OD).
    Herath, Manjula
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Effect of Drilling Preparation on Immediately Loaded Implants: An In Vivo Study in Sheep2023Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 38, nr 3, s. 607-618Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To determine the biologic and biomechanical effects of two implant drilling protocols on the cortical bone around implants subjected to immediate loading. Materials and Methods: A total of 48 implants were inserted into the mandibles of six sheep following one of two drilling protocols: undersized preparation (US; n = 24) and nonundersized preparation (NUS; n = 24). Immediately after implant insertion, an abutment was placed on each implant and 36 implants were subjected to 10 sessions of dynamic vertical loads (1,500 cycles, 1 Hz) of 25 N or 50 N. Insertion torque value (ITV) was recorded at implant installation. Resonance frequency analysis (RFA) was measured at implant insertion and at each loading session. Fluorochrome was administered at day 17, and the animals were euthanized after 5 weeks. The removal torque values (RTVs) were measured, and samples underwent histomorphometric, mu CT (microcomputed tomography), and fluorescence image acquisition analyses. The bone volume density (BV/TV), bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), and fluorochrome stained bone surface (MS) were calculated. A linear mixed model analysis was performed, and Pearson paired correlation was calculated. Results: Five implants from the NUS group failed, with a mean ITV of 8.8 Ncm and an RFA value of 57. The mean ITVs for US group and NUS group were 80.5 (+/- 14) Ncm and 45.9 (+/- 25) Ncm, respectively (P < .001). No differences were noted in the RFA values from the time of implant insertion until the end of the study. No differences in RTV, BV/TV, BAFO, or MS were observed between the groups. Intense new bone formation took place in the NUS group implants that were subjected to load. Conclusions: Undersized preparation of cortical bone ensured a greater BIC compared to a nonundersized preparation. Moreover, this study demonstrated that immediate loading did not interfere with the osseointegration process, but loading induced intense new bone formation in the NUS group. It is not recommended to immediately load the implants when the clinically perceived primary stability is lower than an ITV of 10 Ncm and an RFA value of 60.

  • 28.
    Stocchero, Michele
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Toia, Marco
    Malmö högskola, Odontologiska fakulteten (OD).
    Cecchinato, Denis
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Coelho, Paulo G
    Jimbo, Ryo
    Malmö högskola, Odontologiska fakulteten (OD).
    Biomechanical, Biologic, and Clinical Outcomes of Undersized Implant Surgical Preparation: A Systematic Review2016Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 31, nr 6, s. 1247-1263Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    PURPOSE: To compile the current evidence on biomechanical, biologic, and clinical outcomes of undersized surgical preparation protocols in dental implant surgery. MATERIALS AND METHODS: An electronic search using three different databases (PubMed, Web of Science, and Cochrane Library) and a manual hand search were performed including in vitro, animal, and clinical studies published prior to October 2015. Studies in which an undersized drilling protocol was compared with a nonundersized drilling protocol were included. RESULTS: From an initial selection of 1,655 titles, 29 studies met the inclusion criteria, including 14 biomechanical, 7 biologic, 6 biologic and biomechanical, and 2 clinical. Due to methodologic variation, meta-analysis was not performed. Several studies showed that implants inserted with an undersized drilling approach reached a significantly higher insertion torque value than conventional drilling in low-density substrates, while this effect is less evident if a thick cortical layer is present. Similar results in terms of boneto-implant contact (BIC) were achieved in the longer term between implants inserted with undersized and nonundersized protocols. Results in the short term were inconclusive. Clinical studies did not show negative outcomes for undersized drilling, although clinical evidence was sparse. No data are available on marginal bone loss. CONCLUSION: From the biomechanical standpoint, an undersized drilling protocol is effective in increasing insertion torque in low-density bone. Biologic response in long-term healing after undersized implant placement is comparable to that in the nonundersized surgical drilling protocol. Clinical studies indicate that performing an undersized drilling protocol on low-density bone is a safe procedure; however, more extensive studies are needed to confirm these data.

  • 29. Sul, Young-Taeg
    et al.
    Byon, Eungsun
    Wennerberg, Ann
    Malmö högskola, Odontologiska fakulteten (OD).
    Surface characteristics of electrochemically oxidized implants and acid-etched implants: surface chemistry, morphology, pore configurations, oxide thickness, crystal structure, and roughness2008Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 23, nr 4, s. 631-640Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study was undertaken to investigate surface properties of surface-modified titanium implants in terms of surface chemistry, morphology, pore characteristics, oxide thickness, crystal structure, and roughness. MATERIALS AND METHODS: An oxidized, custom-made Mg implant, an oxidized commercially available implant (TiUnite), and a dual acid-etched surface (Osseotite) were investigated. Surface characteristics were evaluated with various surface analytic techniques. RESULTS: Surface chemistry showed similar fingerprints of titanium oxide and carbon contaminant in common for all implants but also revealed essential differences of the elements such as about 9 at% Mg for the Mg implant, about 11 at% P for the TiUnite implant and about 12 at% Na for the Osseotite implant. Surface morphology of the Mg and TiUnite implants demonstrated a duplex oxide structure, ie, an inner barrier layer without pores and an outer porous layer with numerous pores, whereas the Osseotite implant revealed a crystallographically etched appearance with pits. The diameter and depth of pores/pits was < or = 2 microm and < or = 1.5 microm in the Mg implant, < or = 4 microm and < or = 10 microm in the TiUnite implant, and < or = 2 microm and < or = 1 microm in the Osseotite implant, respectively. Oxide layer revealed homogeneous thickness, about 3.4 microm of all threads in the Mg implants. On the contrary, TiUnite showed heterogeneous oxide thickness, about 1 to 11 microm, which gradually increased with thread numbers. Crystal structure showed a mixture of anatase and rutile phase for the Mg implants. With respect to roughness, Sa showed 0.69 microm in the Mg implant, 1.35 microm in the TiUnite implant, and 0.72 microm in the Osseotite implant. CONCLUSIONS: Well-defined surface characterization may provide a scientific basis for a better understanding of the effects of the implant surface on the biological response. The surface-engineered implants resulted in various surface characteristics, as a result of different manufacturing techniques.

  • 30.
    Toia, Marco
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö högskola, Odontologiska fakulteten (OD).
    Cecchinato, Francesca
    Corra, Enrico
    Jimbo, Ryo
    Malmö högskola, Odontologiska fakulteten (OD).
    Cecchinato, Denis
    Clinical Considerations of Adapted Drilling Protocol by Bone Quality Perception2017Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 32, nr 6, s. 1288-1295Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To evaluate insertion torque value ( ITV) and marginal bone loss (MBL) of an implant system after a clinically perceived bone quality-adapted drilling. Materials and Methods: This multicenter retrospective study included patients treated with implants, conventionally loaded, in completely healed sites. Operators customized the osteotomy preparation according to radiographic assessment and their perception of bone quality. Drilling sequence, bone quality, and ITV were recorded at the time of surgery. Radiographs were taken at the time of implant placement and permanent restoration. MBL between implant placement and permanent restoration was calculated. The implant was used as the statistical unit. Demographic and implant characteristics were shown by means of descriptive statistics. Outcome values were compared using analysis of variance (ANOVA) and Kruskal-Wallis tests. Multiple regression models were used to test the effect of independent variables on ITV and MBL. Results: One hundred eighty-eight implants placed in 87 patients were included in the analysis. The mean observation period was 144 +/- 59 days. The mean ITV was 30.8 +/- 15.1 Ncm. ITV differed significantly based on arches (mandible/maxilla) (P = .001), bone quality (P < .001), implant diameter (P = .032), and drilling protocol (P = .019). Median MBL was 0.05 mm (0.00; 0.24). A significant difference was found between the mandible and maxilla (P = .008) and between drilling protocols (P = .011). In particular, significantly higher MBL was found in the undersized drilling protocol. Multiple regression analysis showed that ITV was influenced by bone quality and implant diameter. MBL was influenced by bone quality, implant diameter, ITV, and the interaction between bone quality and ITV. It was estimated that MBL was greater with increased bone density and ITV. Conclusion: Excessive ITV in dense bone can cause negative marginal bone responses. A presurgical radiographic assessment and the perception of bone quality are necessary to select an optimal drilling protocol and to minimize surgical trauma.

  • 31.
    Toia, Marco
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Jinno, Yohei
    Malmö universitet, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Halldin, Anders
    Effect of Misfit at Implant-Level Framework and Supporting Bone on Internal Connection Implants: Mechanical and Finite Element Analysis2019Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 34, nr 2, s. 320-328Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To evaluate the effect of misfit at implant-level fixed partial dentures (ILFPDs) and marginal bone support on the generation of implant cracks. Materials and Methods: This in vitro study included a mechanical fatigue test and finite element analysis. A mechanical cycling loading test was performed using 16 experimental models, each consisting of two parallel implants subdivided into four groups based on the misfit and the supporting bone condition. The framework, firmly seated at implants, was dynamically loaded vertically with a force of 1,600/160 N and 15 Hz for 1 × 106 cycles. Optical microscope, scanning electron microscope (SEM), and computed tomography three-dimensional (CT-3D) analyses were performed to detect impairments. Finite element models, representing the setups in the mechanical fatigue test, were used to represent the fatigue life. Results: None of the mechanical components presented distortion or fracture at the macroscopic level during the test. In a microscopy evaluation, the fatigue test revealed scratches visible in the inner part of the conical portion of the implants regardless of the groups. SEM and CT-3D analysis revealed one implant from the misfit/no bone loss group with a microfracture in the inner part of the conical interface. The simulated effective stress levels in the coronal body were higher in the misfit groups compared with the no misfit groups. The misfit groups presented effective stress levels, above 375 MPa, that penetrated the entire wall thickness. The no bone loss group presented an effective stress level above 375 MPa along its axial direction. In the no misfit group, the area presenting effective stress levels above 375 MPa in the conical connection was larger for the bone loss group compared with the no bone loss group. Conclusion: This study confirmed that implant fracture is an unlikely adverse event. A clear pattern of effective distribution greater than fatigue limit stresses could be noticed when the misfit was present. The dynamic load simulation demonstrated that the crack is more likely to occur when implants are fully supported by marginal bone compared with a bone loss scenario. Within the limitations of this study, it is speculated that marginal bone loss might follow the appearance of an undetected crack. Further research is needed to develop safe clinical protocols with regard to ILFPD.

  • 32.
    Wennerberg, Ann
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Albrektsson, Tomas
    Gothenburg Univ, Dept Biomat, S-41124 Gothenburg, Sweden.
    On implant surfaces: a review of current knowledge and opinions2010Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 25, nr 1, s. 63-74Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of the present review are (1) to identify essential surface parameters; (2) to present an overview of surface characteristics at the micrometer and nanometer levels of resolution relevant for the four most popular oral implant systems; (3) to discuss potential advantages of nanoroughness, hydrophilicity, and biochemical bonding; and (4) to suggest a hypothetical common mechanism behind strong bone responses to novel implant surfaces from different commercial companies. Oral implants from four major companies varied in average surface roughness (Sa) from 0.3 to 1.78 microm and in the developed surface area ratio (Sdr) from 24% to 143%, with the smoothest implants originating from Biomet 3i and the roughest from Institut Straumann. The original Branemark turned, machined surface had an Sa of 0.9 microm and an Sdr of 34%, making it clearly rougher than the smoothest implants examined. When evaluated for nanometer roughness, there was a substantial variation in Sa in the different implants from the four major companies. Novel implants from Biomet 3i, AstraTech, and Straumann differed from their respective predecessors in microroughness, physicochemical properties, and nano_roughness. When examined with scanning electron microscopy at high magnification, it was noted that these novel implant surfaces all had particular nanoroughness structures that were not present in their respective predecessors; this finding was suggested as a possible common mechanism behind the demonstrated stronger bone responses to these implants compared to adequate controls.

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